Cyto-morphological investigation of cellular content of peripancreatic liquid accumulations in estimation of the clinical course severity in an acute complicated pancreatitis
Abstract
Objective. To study up a character and peculiarities of cyto-morphological changes in cellular material of the peripancreatic liquid accumulations (LA) as a criterion of objective estimation of the clinical course severity in an acute complicated pancreatitis (ACP).
Маterials and methods. Results of cyto-morphological investigation of the peripancreatic LA sediment, obtained while doing interventional ultrasonography in 51 (88%) observations and videolaparoscopy - in 7 (12%) observations in 58 patients with an ACP, were analyzed.
Results. Of intraabdominal LA (n=37) observations in 10 (27 %) of them a domination of proliferating cells of mesothelium with their polymorphism was revealed, while in 15 (41%) - degenerative-dystrophic changes like a bulging of cytoplasm, appearance of large «signet-ring like» cells, in 12 (32%) - аtipically changed cells of mesothelium with signs of anizocytosis and anizonucleosis, as well as cyto-morphological changes like in neoplastic process. In retroperitoneal localization of LA (n=21) a more essential changes in the granulocytes nuclei were registered, including, in 9 (43%) observations their structure have got irreversible disorders: karyopycnosis, karyorexis and karyolysis. The depth of structural cellular changes in mesoteliocytes and neutrophil granulocytes have depended upon the ACP severity.
Conclusion. Determination of depth of the cellular content cytomorphological disorders in the LA sediment may serve an objective criterion in the ACP severity estimation.
References
2. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15. doi: 10.1016/j.pan.2013.07.063.
3. Aitken EL, Gough V, Jone A. Observation study of intra-abdominal pressure monitoring in acute pancreatitis. Surgery. 2014 May;155(5):910-8. doi: 10.1016/j.surg.2013.12.028.
4. Andriushchenko VP, Kohut LM, Andrushevska OYu, vynakhidnyky; Danylo Halytsky Lviv National Medical University, patentovlasnyk. Sposib otsinky tiazhkosti hostroho nekrotychnoho pankreatytu. Patent Ukrainy No 18983. 2006 List 15. [In Ukrainian].
5. Andriushchenko DV, Kohut LM, Andrushevska OYu, Andriushchenko VP, vynakhidnyky; Danylo Halytsky Lviv National Medical University, patentovlasnyk. Sposib prohnozuvannia klinichnoho perebihu hostroho destruktyvnoho pankreatytu. Patent Ukrainy No 106268. Ukraina MPK G01N 33/48. / zaiavnyky ta patentovlasnyky. 2016 Kvit 25. [In Ukrainian].
6. Nychytailo MYu, Andriushchenko DV, Mahlovanyi VA, Andriushchenko VP. Kharakterystyky suchasnoho bakteriinoho chynnyka pry hostromu pankreatyti ta yikh klinichne znachennia dlia obgruntuvannia likuvalnoi taktyky. Mezhdunarodnyi zhurnal antybyotyky y probyotyky. 2017;(2):61-72.
7. Bollen TL, Singh VK, Maurer R, Repas K, van Es HW, Banks PA, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis. Am J Gastroenterol. 2012 Apr;107(4):612-9. doi: 10.1038/ajg.2011.438.
8. Rusyn VI, Filip SS. Hidrotorakc - predyktor vazhkosti protikannia hostroho pankreatytu. Ukrainskyi zhurnal khirurhii. 2012;(3):5-8. [In Ukrainian].
9. Hodlevskyi AI, Savoliuk SI, Melnyk TO. Prohnostychne znachennia pokaznykiv systemy erytronu ta obminu zaliza u khvorykh na hostryi pankreatyt. Zbirnyk naukovykh robit XXIII z′izdu khirurhiv Ukrainy: Kyiv; 2015. 639-40. [In Ukrainian].
10. Homoliako IV, Tumasova KP, Klochkova NYe. Indeks poshkodzhennia systemy neitrofiliv yak faktor prohnozu khirurhichnykh uskladnen. Klinichna khirurhiia. 2013;(4 Suppl):11-2. [In Ukrainian].
This work is licensed under a Creative Commons Attribution 4.0 International License.